HIV感染者并发肺结核发病特征及危险因素分析  

Pathogenesis characteristics of patients with HIV infection complicated with pulmonary tuberculosis and analysis of risk factors

作　　者：林润英[1] 李桓[1] 刘敏[1] 

机构地区：[1]重庆市公共卫生医疗救治中心感染二科,重庆400036

出　　处：《西南国防医药》2015年第7期734-737,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的 探讨HIV感染者并发肺结核的发病特征及危险因素,为其预防提供参考。方法 对196例HIV感染者进行为期3年的跟踪随访,统计并发肺结核发生率、首发症状、发病距确诊HIV感染时间、临床特征及危险因素,包括是否有结核家族史、结核接触史,是否抗HIV治疗,是否吸烟、饮酒,是否吸毒及方式,是否为同性恋,居住环境是否通风,有无卡介苗接种史,是否劳累、贫困,是否经常体育锻炼等。结果 196例中,188例成功随访,随访期间并发肺结核38例（20.2%）,发病距初诊HIV感染时间为3~26个月;发生于HIV感染急性期4例,无症状期12例,艾滋病期22例。首发症状以发热（47.4%）、咳嗽（31.6%）、咯血（10.5%）为主。结核接触史、吸烟、饮酒、吸毒、劳累、贫困是并发肺结核的危险因素,而抗HIV治疗、居住环境通风、卡介苗接种史是并发肺结核的保护因素。结论 HIV感染并发肺结核的首发症状以发热为主,好发于艾滋病期,结核接触史、吸烟、饮酒、吸毒、劳累、贫困是HIV感染者并发肺结核的危险因素。Objective To discuss the pathogenesis characteristics of patients with HIV infection complicated with pulmonary tuberculosis and the risk factors, and to provide references for its prevention. Methods Follow-up had been made in 196 patients infected with HIV for 3 years. Analysis was made in the incidence of pulmonary tuberculosis, first symptom, the period between the morbidity and the final diagnosis of HIV infection, clinical characteristics, and risk factors including whether having family history of tuberculosis, the contact history with tuberculosis, anti-HIV treatment, smoking, drinking, drug abuse, homosexuality, ventilation of inhabited environment, BCG vaccination, tiredness, poverty, and whether usually doing physical exercises. Results Among the 196 cases, 188 ones were successfully followed up. During the follow-up, and 38 patients （20.2%） were complicated with pulmonary tuberculosis. The period between pulmonary tuberculosis and the final diagnosis of HIV infection was 3 months to 26 months. There were 4 cases having the incidence during the acute stage of HIV infection, 12 ones in the symptomless period, and 22 ones in AIDS period. The first symptoms mainly were fever （47.4%）, cough （31.6%）, and hemoptysis （10.5%）. The risk factors of pulmonary tuberculosis included the contact history with tuberculosis, smoking, drinking, drug abuse, tiredness, and poverty. However anti-HIV treatment, ventilation of inhabited environment, and BCG vaccination were the protection factors. Conclusion The first symptom of patients with HIV infection complicated with pulmonary tuberculosis is mainly fever which is prone to occur during AIDS period. The contact history with tuberculosis, smoking, drinking, drug abuse, tiredness, and poverty are the risk factors.

关 键 词：HIV感染 肺结核 危险因素 发病特征 

分 类 号：R512.91[医药卫生—内科学]